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GERD Drugs and Bone Health

If you have GERD (gastroesophageal reflux disease), your stomach acid backs up into your esophagus. You may be taking a type of drug called a proton pump inhibitor (PPI), which may or may not require a prescription.  PPIs include:

  • esomeprazole (Nexium)
  • lansoprazole (Prevacid)
  • omeprazole (Prilosec, Zegerid)

Over-the-counter PPIs include versions of Prevacid 24HR, Prilosec OTC, and Zegerid OTC.

In 2010, the FDA warned that taking high doses of PPIs for a long time may make fractures of the hip, wrist, and spine more likely. The FDA ordered a labeling change on the medicines to note the risk.

Other drugs, called H2 blockers, curb the production of stomach acid. H2 blockers include:

  • cimetidine (Tagamet)
  • famotidine (Calmicid, Fluxid, Mylanta AR, Pepcid)
  • ranitidine (Tritec, Zantac)

These drugs may be more bone-friendly, according to Kearns, but that's not certain yet.

Diabetes Drugs and Your Bones

Research about the effect of some diabetes drugs on bone health has been accumulating, says Chad Deal, MD, head of the Center for Osteoporosis and Metabolic Bone Diseases at the Cleveland Clinic.

Many recent studies have shown that a kind of diabetes drugs known as thiazolidinediones have a negative effect on the bones, according to Deal and Kearns. Examples of these drugs include:

  • pioglitazone (Actos)
  • rosiglitazone (Avandia)

There are other types of diabetes drugs, so that may be something for you and your doctor to consider when you're going over all your medications.

Bone-Maintenance Drugs

Bisphosphonates are a type of osteoporosis drug. They include:

  • alendronate (Binosto, Fosamax)
  • ibandronate (Boniva)
  • risedronate (Actonel, Atelvia)
  • zoledronic acid (Reclast)

Some studies linked their long-term use to a greater chance of an uncommon fracture of the thigh bone.

If someone who's been taking a bisphosphonate for a long time has that rare type of thigh bone fracture, their doctor should switch them to another type of osteoporosis drug, Deal says.

The following drugs are among the alternatives to bisphosphonates for either treating or preventing osteoporosis:

  • denosumab (Prolia). This is a biologic drug that slows bone loss.
  • raloxifene (Evista)
  • teriparatide (Forteo). This is a type of parathyroid hormone that increases bone formation.
  • Hormone replacement therapy
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